Renal osteodystrophy affects nearly all children with chronic renal failure, and growth retardation is a major clinical consequence; accordingly, recombinant human growth hormone (rhGH) has been used to enhance linear growth in pediatric patients with end-stage renal disease. Little is known, however, about the effects of rhGH therapy in bone formation and parathyroid gland function in children with renal osteodystrophy.